(1) Background: the present study continues previous research on new marking techniques by using intelligent materials, NFC-tags (Near Field Communication tags) and Aerogel. They prevent the loss of information over time for cadavers of unknown identities in various stages of destruction or unknown living victims, as well as missing persons who have lost or are concealing their identity. (2) Methods: this study consisted of a technological and an experimental stage. In the technological stage, two different sizes were used: round (Ø 1 cm, 0.1 mm thickness, 0.1 g weight) and square (5/5/0.1 mm), both with a 140 byte memory and high-temperature resistance (at max. 200 °C), (by the classical producing technology). After loading the identification information on the NFC-tags, they were embedded (either alone or protected by Aerogel) in the sample dentures using a new “sandwich technique” method, before the polymerization process. In the experimental stage, the sample dentures with the new materials were exposed to various damaging environments such as liquid media (sea water, fresh water, alcohol 40%, and HCl 0.2%) in order to test the time resistance of the identification elements. The samples were monitored and tested over four years. (3) Results: the information stored on the NFC tags was retrieved unaltered at the end of the monitoring period, regardless of the damage caused by the liquid media to the sample denture material and will provide an innovative solution as compared to other labeling methods. (4) Conclusion: the use of intelligent materials for labeling acrylic dentures provides additional reliability by preserving the identification information over time.

This systematic review examines chronic kidney disease-associated pruritus (CKD-aP) as a complex clinical manifestation in patients undergoing hemodialysis. Traditionally considered a secondary symptom of end-stage renal disease, emerging evidence now positions CKD-aP as a multidimensional disorder with substantial pathogenic influence on patient outcomes. Using the PRISMA 2020 methodology, we critically evaluated 54 peer-reviewed studies published between 2020 and 2025. Our synthesis highlights a convergence of five mechanistic frameworks underpinning CKD-aP: elevated levels of uremic toxins originating from gut microbial dysbiosis, immune activation driven by IL-31 and other pro-inflammatory cytokines, heightened peripheral and central neural sensitization, dysregulation of endogenous opioid receptor pathways favoring μ-receptor activation, and xerosis-related epidermal barrier dysfunction. These mechanisms contribute to a systemic cycle of microinflammation, pruritogenic signaling, and neural hyperexcitability. We also identified and compared validated assessment tools—including the NRS, VAS, Skindex-10, and the UP-Dial scale—that facilitate standardized quantification of disease burden. While available treatments such as gabapentinoids and phototherapy offer partial relief, targeted therapies—including κ-opioid receptor agonists—represent a major advancement, although long-term effectiveness and accessibility remain under investigation. Growing scientific consensus establishes CKD-aP as a priority therapeutic target in hemodialysis care, underscoring the need for integrated, mechanism-based management strategies to improve quality of life and clinical outcomes. This work represents a narrative systematic review, integrating evidence from mechanistic, translational, and clinical studies to critically examine the biological pathways underlying CKD-associated pruritus.

Background/Objectives: Burnout is a critical concern among healthcare professionals, particularly during crises such as the COVID-19 pandemic. This study investigated burnout levels among forensic medicine and pathology personnel at three distinct phases: the early pandemic period (Phase 1—September 2020), the peak of the pandemic (Phase 2—October 2021), and the post-pandemic period (Phase 3—October 2024). Methods: A total of 37 participants employed in forensic medicine and pathology departments completed the Maslach Burnout Inventory (MBI). A one-way repeated measures ANOVA was conducted to assess within-subject differences over time. Normality and sphericity were tested using the Shapiro–Wilk test and Mauchly’s test, with the Greenhouse-Geisser correction. Post hoc Bonferroni-adjusted comparisons identified significant differences, and partial eta squared (η²) was reported for effect sizes. Results: Results showed significant fluctuations in burnout levels across the three phases. Emotional exhaustion and low personal accomplishment peaked during Phase 2, with slight reductions observed in Phase 3. Gender differences were evident, with females reporting higher EE levels and males exhibiting higher depersonalization across all phases. Marital and parental status also influenced burnout levels, with unmarried individuals and those without children showing higher burnout scores. Medical doctors experienced the highest burnout levels among professional roles, while auxiliary staff showed significant challenges in the PA subscale. Conclusions: The COVID-19 pandemic was pivotal in exacerbating burnout levels due to increased workload, crisis decision-making, and emotional toll. Although the sample size is limited, these findings underscore the importance of implementing targeted interventions to mitigate burnout among forensic and pathology personnel, especially during healthcare emergencies. Gender-based differences in burnout suggest the necessity of specific workplace well-being strategies, while the protective role of family status demonstrates the importance of work-life balance policies. The persistence of psychological distress after a medical crisis calls for long-term monitoring and support programs. There is a need for improved workload distribution, peer support networks, and mental health training to build resilience among forensic and pathology personnel.

Background and Objectives: Burnout syndrome is increasingly recognized as a significant occupational hazard among forensic medicine professionals, a population exposed to intense psychological stress and complex work demands. This study aimed to assess the prevalence of burnout, job satisfaction, and unconditional self-acceptance among forensic personnel in Romania and to explore potential predictors and mediators of burnout within this context. Materials and Methods: A cross-sectional survey was conducted among 153 forensic medicine professionals from 31 counties across Romania. Participants completed a battery of standardized instruments, including the Maslach Burnout Inventory—General Survey (MBI-GS), the Job Satisfaction Survey (JSS), and the Unconditional Self-Acceptance Questionnaire (USAQ). Cut-off scores for burnout subscales were established using the 75th percentile. Data were analyzed to identify demographic, occupational, and psychological correlates of burnout. Descriptive statistics were used to summarize sample characteristics and burnout prevalence. Group comparisons were made across demographic and professional categories. A mediation model was tested to evaluate whether unconditional self-acceptance mediated the relationship between job satisfaction and burnout. We hypothesized that job satisfaction would be negatively associated with burnout symptoms and that unconditional self-acceptance would mediate this relationship, acting as a protective psychological factor. Results: Approximately a quarter of respondents met the criteria for high total burnout, emotional exhaustion, and professional inefficacy, while cynicism was present in a fifth of participants. Burnout was more prevalent among younger workers, forensic medicine residents, and those working in the capital. Job satisfaction was generally high, but lower in women, younger individuals, and residents. Nearly half of the participants reported low or very low self-acceptance. Mediation analysis revealed that unconditional self-acceptance partially mediated the relationship between job satisfaction and burnout, suggesting a protective psychological mechanism. Conclusions: This study highlights the considerable burden of burnout among forensic medicine professionals in Romania and identifies job dissatisfaction and low self-acceptance as key contributors. Findings underscore the need for targeted interventions aimed at enhancing job satisfaction and emotional resilience, particularly in vulnerable subgroups. Institutional efforts that support mental well-being, foster emotional coping, and improve organizational dynamics are essential to reduce burnout in this high-risk population.

Burnout syndrome is increasingly recognized as a significant occupational health issue, characterized by emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment. It predominantly arises from chronic work-related stress, but recent research has highlighted the role of genetic and epigenetic factors in determining individual vulnerability to burnout. This review aims to synthesize findings regarding the genetic footprints of burnout, focusing on genes related to stress regulation, including the 5-HTT (serotonin transporter) gene, BDNF (brain-derived neurotrophic factor) gene, and NR3C1 (glucocorticoid receptor) gene. Twin studies reveal that burnout is moderately heritable, with genetic factors accounting for 33–36% of the variability in burnout-related traits, such as emotional exhaustion and performance-based self-esteem. However, burnout risk seems highly driven by non-shared environmental factors, such as work stress, lack of social support, and personal coping mechanisms. Specific genetic polymorphisms in the serotonergic system (5-HTT) and HPA axis genes (NR3C1, FKBP5) have been linked to increased burnout susceptibility, particularly in individuals exposed to chronic job strain or early-life stressful situations. Variations in 5-HTT rs6354 and HTR2A rs6313 are associated with altered stress reactivity, while polymorphisms in NR3C1 and FKBP5 contribute to dysregulation of the HPA axis, which influences cortisol secretion patterns in response to stress. Increased methylation in genes like BDNF and SLC6A4 has been observed in individuals with burnout, suggesting that environmental stressors may lead to lasting changes in gene expression, contributing to the syndrome’s development. Studies on telomere length have shown that burnout is associated with accelerated cellular aging, with individuals exhibiting shorter telomeres, particularly during high-stress periods. These findings hold particular relevance for professionals within the forensic and justice systems, including law enforcement, the judiciary, and forensic experts, who operate under chronic, high-stakes stress. We examine how understanding the biological basis of burnout can inform more objective ‘fitness-for-duty’ evaluations and provide a scientific framework for distinguishing physiological exhaustion from professional negligence in legal contexts.

Advanced chronic kidney disease (CKD) presents a complex hemostatic paradox, characterized by a simultaneous increase in bleeding and thromboembolic risks. This study aimed to evaluate and compare the safety and efficacy of apixaban versus acenocoumarol in a real-world cohort of patients across advanced CKD stages (pre-dialysis and hemodialysis). We conducted a retrospective observational study including 84 adults with CKD stages 4 and 5 (40.5% in stage 4; 59.5% in stage 5, of whom 86.0% were on chronic hemodialysis) receiving oral anticoagulation for at least 3 months. Patients were stratified by CKD stage and anticoagulant type (apixaban vs. acenocoumarol). Clinical outcomes included major and clinically relevant bleeding, anticoagulant overdose, and thromboembolic events. Bleeding events were more frequent in CKD stage 5 than in stage 4 (66.0% vs. 44.1%, p = 0.06), highlighting a pronounced hemorrhagic burden that increases with disease progression. Apixaban was associated with significantly fewer total bleeding events (44.4% vs. 66.7%, p = 0.04) and a lower rate of anticoagulant overdoses (5.6% vs. 18.8%, p = 0.04) compared with acenocoumarol. Thromboembolic event rates did not differ significantly between the two anticoagulant groups (13.9% vs. 16.7%, p = 0.72). Conventional risk scores (CHA₂DS₂-VASc and HAS-BLED) showed limited discriminatory capacity for actual clinical events in this advanced CKD population. In patients with advanced CKD, oral anticoagulation is associated with a high hemorrhagic burden that intensifies as renal function declines. Apixaban demonstrated a more favorable safety profile than acenocoumarol without a loss of thromboembolic protection. These findings suggest that stage-specific biological factors, rather than conventional risk models alone, should guide anticoagulation strategies in this population.